Health Coverage Programs
Also known as Health Care Reform, this was signed into law in March 2010.
What is the Affordable Care Act?
An individual who intends to file a tax return and does not expect to be claimed as a tax dependent by someone else.
What is a tax filer?
With the exception of property, verifications are considered current if they are within ___ days.
What is 90 days?
Regardless of immigration status or citizenship verification, these individuals are eligible for full-scope Medi-Cal benefits.
Who are children and young adults up to the age of 26, and adults 50 or older?
SSApp
CF 285 / CF37
SAWS 2 Plus
What are Statement of Facts (SOF)?
This statewide system determines eligibility for health programs only, except Non-Magi.
WHat is CalHEERS?
This household is constructed on whether an individual is a tax filer, tax dependent, or a non-filer.
What is a MAGI Medi-Cal household?
When information provided by the individual is consistent with the information obtained from the data hub.
What is reasonably compatible?
This eligibility category allows certain immigrants who are not U.S. Citizens or eligible non-citizens to receive full scope benefits. These categories of immigrants are listed on the MC 13.
What is PRUCOL?
If the client returns a renewal packet and all requested information during this period, the case is rescinded and processed as if the renewal was received timely.
What is the 90-day cure period?
Health care eligibility for low-income individuals and families is based on these rules.
What is MAGI (federal tax rules)?
They do not expect to file a tax return and do not expect to be claimed as a tax dependent by someone else.
What is a Non-Tax Filer?
This form is used to request additional verifications on a continuing case with a 30-day due date.
What is a MC 355?
Worker visa and student visa holders, Deferred Action Status, Lawful Temporary Residents, individuals granted employment authorization only.
Who are non-qualified immigrants that are eligible for restricted benefits?
An applicant, an adult in the applicant's household or family, an Authorized Representative, or someone legally appointed to act on the behalf of a minor or incapacitated applicant.
Who can submit an application?
A subsidized program where a tax credit is available for individuals and families with adjusted gross incomes between 100% and 400% of the FPL, which reduced premium costs.
What is the Advanced Premium Tax Credit?
This household includes self, spouse, and children under 19 (or 21 if a full-time student). If the individual is a child, add parents, step-parents, and siblings under the age of 19 or 21 if a full-time student.
What is the Non-Tax Filer household composition?
The time allowed to comply with DRA requirements when all other verifications have been received.
What is the 90-day Reasonable Opportunity Period (ROP)?
Requested when the initial immigration status information is not e-verified by the CalHEERS BRE, or the Primary SAVE response is to "Institute Secondary Verification".
What is Secondary SAVE?
What is 45 days?
Individuals with adjusted gross income above 400% of the FPL are eligible for this.
What are unsubsidized programs?
The taxpayer, spouse (if living together), and all individuals whom the taxpayer expects to claim as a dependent for the upcoming year.
What is a tax filer's household size?
Income that is available to an applicant only if they claim or accept the income, such as Unemployment Insurance Benefits, or Veteran's Benefits.
What is Unconditionally Available Income?
When the Additional Verification Process could not verify immigration status and staff obtains additional documents from the individual.
What is Third Step Verification?
This opportunity is available for 60 days from the date of a Qualifying Life Event.
What is the Special Enrollment Period?